Reform in Action: Reducing Avoidable Hospital Readmissions

Patients discharged from U.S. hospitals return far too often. Almost one in five elderly patients released from a hospital is back within 30 days, and more than one in three are back within 90 days. Although some readmissions are part of a patient’s treatment plan, many are avoidable.

In this Reform in Action brief, lessons from Aligning Forces for Quality (AF4Q) and RWJF demonstrate how hospitals and health care organizations are addressing the problem of avoidable readmissions by taking steps to help patients get the care they need.

10 Things You Should Know About Care Transitions

Resources For Providers

Reducing Avoidable Readmissions through Better Care Transitions

Traditionally, efforts to reduce avoidable readmissions have focused on hospitals, but it is becoming clear that many factors along the care continuum influence readmissions. These innovative national models take a broader view of care transitions, and are implementing a variety of interventions aimed at reducing avoidable readmissions.

Resources For Patients

How to Avoid Being Readmitted to the Hospital

Traditionally, efforts to reduce avoidable readmissions have focused on hospitals, but it is becoming clear that many factors along the care continuum influence readmissions. These innovative national models take a broader view of care transitions, and are implementing a variety of interventions aimed at reducing avoidable readmissions.

Hospital Discharge Checklist and Care Transition Plan

Asking questions, asking for a plan, and making sure you know what do to if your symptoms get worse can help you stay out of the hospital. If your hospital does not provide similar tools, use the Care About Your Care discharge checklist and care transition plan.

What Works to Improve Care?

A collection of success stories from the front lines of American health care provides free access to strategies used by hospitals and medical practices nationwide to improve care. This library of innovations is based on years of Robert Wood Johnson Foundation-funded hospital and community-based health care quality improvement initiatives.